Contract dispute could affect Premera Blue Cross members

By Keri Brenner | The Olympian • Published September 20, 2008

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OLYMPIA – If a contract standoff is not resolved, 16,000 Premera Blue Cross members in Thurston County could face higher out-of-pocket costs for medical treatments at Providence St. Peter Hospital and other Providence Health & Services facilities after Jan. 31.

The current contract between Providence Health & Services, the state's biggest health care provider, and Mountlake Terrace-based Premera Blue Cross expires then. Both sides are warning employees, clients and members that things are up in the air for 2009.

If the dispute is not resolved, doctor or hospital visits to Providence facilities will be considered "out of network" for patients with Premera Blue Cross coverage after Jan. 31. That means patients would have to pay more of their own money to see the same doctors and to receive the same treatments.

Premera Blue Cross has 1.4 million members statewide, including 16,000 in Thurston County and 7,000 in Lewis County, Premera spokesman Mark Stuart said.

"We're hopeful that we're going to come to a resolution and not cause this kind of disruption to our patients, but we felt we needed to start alerting our internal staff so that they could pass that information around," said Karina Jennings, regional spokeswoman for Seattle-based Providence Health & Services. "This is a critical time because it's open enrollment period."

Jennings was referring to a memo sent last week to Providence's 14,000 physicians and employees statewide by John Fletcher, the company's chief executive. Fletcher said he was giving an early warning about the stalled talks because the open enrollment period — where employees choose their health care insurance providers for the coming year — is occurring at many workplaces through December. "We didn't want people to say later, 'If I had only known then what was happening, I would have done it differently,' " Jennings said.

She added that Providence was not making any recommendations about whether patients should choose Premera Blue Cross or any other provider. Providence is offering information on insurance coverage at its member hospitals and on its Web site, www.providence.org.